Trauma - Bleeding Flashcards
What is perfusion?
Perfusion is the circulation of blood throughout a tissue or organ in an amount that meets the requirements for the tissues demand for oxygen, nutrients and waste removal
What is the result of hypoperfusion?
Hypoperfusion occurs when a tissues oxygen demand is not met. Persistent hypoperfusion results in shock and eventually cell death and organ dysfunction if not treated.
How can you identify arterial bleeding from venous bleeding?
Arterial bleeding is the most serious type of bleed because of the high pressure and the potential to lose a lot of blood in a short amount of time. It is characterized as bright red “spurting” blood and may be difficult to control.
Venous blood is a darker red color than arterial blood and is characterized by a more steady flow or gushing. It does not spurt like arterial bleeds and is easier to control.
How does human body try to control bleeding on its own?
When bleeding occurs the body naturally tries to stop the bleeding by coagulation, or forming blood clots. Platelets aggregate at the injury site and plug the hole, preventing blood from leaking out. Clotting factors activate a reaction that triggers the formation of fibrin strands, making the clot stronger.
What is hemorrhagic shock?
Hemorrhagic shock is a condition of reduced tissue perfusion due to excessive blood loss that results in inadequate delivery of oxygen to the cells of the body.
What are the 3 levels of shock?
Compensated shock: The body can still compensate for blood loss and is able to maintain blood pressure and brain perfusion by means of vasoconstriction and tachycardia.
Decompensated shock: The late stage of shock when the body is no longer able to maintain blood pressure and perfusion to vital organs decreases
Irreversible shock: The final stage of shock in which the body does not respond to treatment and recovery is impossible due to extensive cell death.
Why is bleeding more significant in children?
Children do not conserve fluids well so they have a lower tolerance for blood loss. Children also have a large surface area to weigh ratio so they get cold easier which leads to coagulation problems and hypothermia in shock. Children have longer compensatory functions but an abrupt decrease in function if the problem is not managed soon enough.
What are some special considerations for bleeding in geriatric patients?
Many geriatric patients take medications that affect their body’s ability to coagulate and compensate for blood loss such as blood thinners, beta blockers, calcium channel blockers and antiarrhythmics. Geriatrics also tend to have other health conditions that are exacerbated by severe blood loss.
What are the steps for managing external hemorrhage?
Apply direct pressure over the wound with a dry, sterile dressing. Hold the pressure dressing in place and wrap it with gauze. Its ok to add more dressings if necessary but do not remove the original one as it will break any blood clots that had formed. If the bleeding is on an extremity and direct pressure is not stopping the bleeding, apply a tourniquet 2-3 inches proximal to the injury and turn it until the bleeding stops. Be sure to mark the time the tourniquet was applied.
How does body temperature affect bleeding management?
Hypotension and hypovolemia due to severe bleeding interrupts the body’s ability to thermoregulate, which can cause hypothermia.
Hypothermia in a bleeding patient can lead to problems with coagulation and acidosis.
What is the main function of blood and what are the 4 components that make up blood?
The main function of blood is to act as a transport system for dissolved gases, hormones, enzymes, waste products and nutrients. The four components of blood are: Red blood cells (erythrocytes) White blood cells (leukocytes) Platelets Plasma
